Healthcare Common Procedure Coding System

**Overview**
This accelerator contains information about healthcare coding related datasets. The Health Care Common Procedure Coding System (HCPCS) is a collection of codes that represent procedures, supplies, products and services which may be provided to Medicare beneficiaries and to individuals enrolled in private health insurance programs.

**Description**
The Health Care Common Procedure Coding System (HCPCS) codes are divided into three levels or groups, Level I, Level II & Level III.

Level I - Codes and descriptors copyrighted by the American Medical Association's Current Procedural Terminology, Fourth Edition (CPT-4). These are 5-position numeric codes representing physician and non-physician services.
Level II - Includes codes and descriptors copyrighted by the American Dental Association's Current Dental Terminology, Fifth Edition (CDT-5). These are 5-position alpha-numeric codes representing primarily items and nonphysician services that are not represented in the level I codes.
Level III - Codes and descriptors developed by Medicare carriers (currently known as Medicare Administrative Contractors; MACs) for use at the local (MAC) level. These are 5-position alpha-numeric codes in the W, X, Y or Z series representing physician and non-physician services that are not represented in the level I or level II codes.

**Benefits**
- Useful for physicians, coders & billing companies, medical students as hcpcs procedure and modifier coding-related information is available
- each year, in the united states, health care insurers process over 5 billion claims for payment and without proper hcpcs information and improper billing medicare or other insurance carriers can reject claims for reimbursement.

**License Information**
The use of John Snow Labs datasets is free for personal and research purposes. For commercial use please subscribe to the [Data Library](https://www.johnsnowlabs.com/marketplace/) on John Snow Labs website. The subscription will allow you to use all John Snow Labs datasets and data packages for commercial purposes.

**Included Datasets**
- [Alpha-Numeric HCPCS Procedure and Modifier Codes](https://www.johnsnowlabs.com/marketplace/alpha-numeric-hcpcs-procedure-and-modifier-codes)
- The Healthcare Common Procedure Coding System (HCPCS) dataset is a collection of codes that represent procedures, supplies, products and services which may be provided to Medicare beneficiaries and to individuals enrolled in private health insurance programs. These files contain the 2016, 2017, 2018, 2019 and 2020 alphanumeric HCPCS procedure and modifier codes and their long and short descriptions.
- [Healthcare Common Procedure Coding System Age Restriction](https://www.johnsnowlabs.com/marketplace/healthcare-common-procedure-coding-system-age-restriction)
- The Healthcare Common Procedure Coding System age restriction dataset lists represented codes that TRICARE (formerly known as the Civilian Health and Medical Program of the Uniformed Services - CHAMPUS) recognizes with age restrictions. The TRICARE contractors need to make sure their age file matches what is on the list or it could result in TRICARE Encounter Data (TED) Records failure.
- [Healthcare Common Procedure Coding System Gender Restriction](https://www.johnsnowlabs.com/marketplace/healthcare-common-procedure-coding-system-gender-restriction)
- The Healthcare Common Procedure Coding System age restriction dataset lists represented codes that TRICARE (formerly known as the Civilian Health and Medical Program of the Uniformed Services - CHAMPUS) recognizes with gender restrictions. The TRICARE contractors need to make sure their gender file matches what is on the list or it could result in TRICARE Encounter Data (TED) Records failure.
- [Healthcare Common Procedure Coding System HCPCS Action Codes 2020](https://www.johnsnowlabs.com/marketplace/healthcare-common-procedure-coding-system-hcpcs-action-codes-2020)
- The Healthcare Common Procedure Coding System (HCPCS) is a collection of codes that represent procedures, supplies, products and services which may be provided to Medicare beneficiaries and to individuals enrolled in private health insurance programs. These files contain the Level II alphanumeric HCPCS procedure and modifier codes and their type of change status.
- [Healthcare Common Procedure Coding System Mapping 2015 and 2019](https://www.johnsnowlabs.com/marketplace/healthcare-common-procedure-coding-system-mapping-2015-and-2019)
- This dataset contains information on 'integrated' Outpatient Code Editor (I/OCE) program processes claims for all outpatient institutional providers including hospitals that are subject to the Outpatient Prospective Payment System (OPPS) as well as hospitals that are NOT (Non-OPPS). This dataset contains HCPCS Codes differences between October, 2015 and January, 2019.
- [Healthcare Common Procedure Coding System Mapping Quarterly Files](https://www.johnsnowlabs.com/marketplace/healthcare-common-procedure-coding-system-mapping-quarterly-files)
- This dataset contains information on 'integrated' Outpatient Code Editor (I/OCE) program processes claims for all outpatient institutional providers including hospitals that are subject to the Outpatient Prospective Payment System (OPPS) as well as hospitals that are NOT (Non-OPPS). This dataset contains the Healthcare Common Procedure Coding System (HCPCS) Codes Mapping Quarterly Files between October, 2015 and January 2016.
- [List of CPT and HCPCS Codes](https://www.johnsnowlabs.com/marketplace/list-of-cpt-and-hcpcs-codes)
- This dataset shows List of Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) Codes (the Code List), which identifies all the items and services included within certain DHS categories or that may qualify for certain exceptions.
- [Medicare Risk Adjustment Eligible CPT and HCPCS Codes](https://www.johnsnowlabs.com/marketplace/medicare-risk-adjustment-eligible-cpt-and-hcpcs-codes)
- This dataset shows List of eligible medicare risk adjustment Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) codes used for filtering diagnoses from encounter data records for each service year 2021 and 2022.
- [Value Modifier PUF Performance Year 2016](https://www.johnsnowlabs.com/marketplace/value-modifier-puf-performance-year-2016)
- This dataset shows the value modifier public use file (PUF) Performance Year 2016 (Payment Year 2018) by the Centers for Medicare and Medicaid Services (CMS).

**Data Engineering Overview**
**We deliver high-quality data**
- Each dataset goes through 3 levels of quality review
- 2 Manual reviews are done by domain experts
- Then, an automated set of 60+ validations enforces every datum matches metadata & defined constraints
- Data is normalized into one unified type system
- All dates, unites, codes, currencies look the same
- All null values are normalized to the same value
- All dataset and field names are SQL and Hive compliant
- Data and Metadata
- Data is available in both CSV and Apache Parquet format, optimized for high read performance on distributed Hadoop, Spark & MPP clusters
- Metadata is provided in the open Frictionless Data standard, and its every field is normalized & validated
- Data Updates
- Data updates support replace-on-update: outdated foreign keys are deprecated, not deleted

**Our data is curated and enriched by domain experts**

Each dataset is manually curated by our team of doctors, pharmacists, public health & medical billing experts:
- Field names, descriptions, and normalized values are chosen by people who actually understand their meaning
- Healthcare & life science experts add categories, search keywords, descriptions and more to each dataset
- Both manual and automated data enrichment supported for clinical codes, providers, drugs, and geo-locations
- The data is always kept up to date – even when the source requires manual effort to get updates
- Support for data subscribers is provided directly by the domain experts who curated the data sets
- Every data source’s license is manually verified to allow for royalty-free commercial use and redistribution.

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